Individual provider Active NPI

Rachel Fennema, DO

  • Family Medicine Physician
  • Tucson, AZ
National Provider Identifier
1770166118
Registry record updated Sep 12, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
011265 Issued in AZ
Practice address
9348 E Rita Rd Ste 140
Tucson, AZ 85747-6301
Phone
(520) 324-4499
NPI assigned
May 4, 2021
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 12, 2024

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
Family Medicine Physician 207Q00000X 011265 AZ Primary

Addresses

Primary practice location

9348 E Rita Rd Ste 140
Tucson, AZ 85747-6301

Mailing address

1919 Lincoln Way Ste 315
Coeur D Alene, ID 83814-2527
Phone (208) 625-6000

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AZ
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240924000960 AZ Practitioner - Family Practice 2466810759 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Chicago College of Osteopathy, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
TMC Medical NetworkGroup PAC ID 9638457013, 276 clinicians

Practice addresses (Care Compare)

9348 E Rita Rd
Suite 180
Tucson, AZ 85747-6312
Phone (520) 324-4499

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of skin lesions1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Osteopathy

State licenses

LicenseStateTypeSpecialty
011265AZMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
TMC Medical Network CurrentSince Nov 11, 2024 Accepting new patients
Saguaro Physicians, LLC Family Medicine PastSince Oct 1, 2007 Accepting new patients

Locations

9348 E Rita Rd
Ste 100
Tucson, AZ 85747
Phone (520) 324-4760

9348 E Rita Rd
Ste 140
Tucson, AZ 85747
Phone (520) 324-1036

2380 N Ferguson Ave
Ste 104
Tucson, AZ 85712
Phone (520) 324-1010

9348 E Rita Rd
Ste 180
Tucson, AZ 85747
Phone (520) 324-4499

Interoperability endpoints

  • Direct secure messaging: rfennema593406@direct.multicare.org

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Hospital & facility affiliations 5

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1620086400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1726099200000",
    "number": "1770166118",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1919 LINCOLN WAY STE 315",
            "city": "COEUR D ALENE",
            "state": "ID",
            "postal_code": "838142527",
            "telephone_number": "208-625-6000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9348 E RITA RD STE 140",
            "city": "TUCSON",
            "state": "AZ",
            "postal_code": "857476301",
            "telephone_number": "520-324-4499"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FENNEMA",
        "first_name": "RACHEL",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-05-04",
        "last_updated": "2024-09-12",
        "certification_date": "2024-09-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "AZ",
            "license": "011265",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tucson, AZ

Sources for this page

Verify at the official NPI Registry.